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A recent study analyzing health and long-term care insurance data from Tsukuba City has provided new insights into the prognosis of older patients who undergo invasive mechanical ventilation. The study highlights that while a majority of patients aged 65 and older who survived more than three days after intubation were successfully weaned from the ventilator, those with higher care needs—particularly those classified as care level 3 or above—tended to experience prolonged hospital stays. These results underscore the importance of considering the potential disadvantages of prolonged hospitalization during discussion about treatment options.

Tsukuba, Japan—Prognostic information is crucial when considering the use of mechanical ventilation. However, there have been few reports detailing the proportion of older patients who are able to be weaned from mechanical ventilation or discharged from the hospital. In this study, researchers examined health and long-term care insurance data from Tsukuba City (April 2014 to March 2019) to investigate the proportion of older patients (aged 65 years or above) who underwent tracheal intubation and mechanical ventilation and were subsequently weaned from the ventilator and discharged from the hospital.

The study included 272 patients, excluding those who underwent ventilation for surgical purposes and those who died within three days of ventilation. Of these, 73.5% were weaned off the ventilator within 180 days, and 42.6% were discharged from the hospital within the same period. In contrast, 37.5% of the patients died within 180 days, and 19.9% remained hospitalized beyond 180 days. When dividing patients by age and care level, no significant differences were observed in the duration of mechanical ventilation or hospitalization across age groups. However, patients with a care level of 3 or higher at admission had a higher proportion of prolonged hospitalization beyond 180 days compared to those with lower care levels.

Although many older patients who survived more than three days after receiving mechanical ventilation via endotracheal intubation were able to be extubated, hospitalization tended to be prolonged in those with a high care level. These findings highlight the need to consider the potential disadvantages of long-term hospitalization. In counseling sessions involving patients, their families, and physicians regarding treatment plans, it may be important to address not only the potential difficulty of ventilator liberation but also the risk of undesired outcomes and physical function decline.

Original Paper

Title of original paper:

Liberation and Discharge Status of Older Patients After Invasive Mechanical Ventilation: A Retrospective Cohort Study

Journal:

BMC Geriatrics

DOI:

10.1186/s12877-025-05963-0

Correspondence

Professor TAMIYA Nanako
Health Services Research and Development Center / Institute of Medicine, University of Tsukuba

SAKAMOTO Ayaka
Doctoral Program in Medical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba
Current Position: Visiting Researcher, Health Services Research and Development Center

Related Link

Institute of Medicine
Department of Health Services Research, Institute of Medicine